According to a new study published online in the Journal of Internal Medicine, Intensive blood pressure (BP) control in nondiabetic patients with moderate-to-advanced chronic kidney disease (CKD) may not lower their cardiovascular risks and could increase their risk of acute kidney injury (AKI).

Yoshitsugu Obi, MD, of the University of California Irvine, and colleagues found that intensive BP control did not reduce the risk of fatal and nonfatal cardiovascular events among 891 patients with an estimated glomerular filtration rate (eGFR) below 45 mL/min/1.73 m2. His findings came from a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial) which consisted of 445 patients who received standard BP control and 446 who received intensive BP control.

AKI developed in 62 patients (13.9%) in the intensive control arm compared with 38 (8.5%) in the standard control arm. Intensive BP control was associated with a significant 73% increased risk of AKI.

Based on the current findings, Dr Obi and colleagues concluded that eGFR significantly modifies the risk-benefit profile of intensive BP control, which may provide little or no benefit and may be harmful to patients with an eGFR below 45 mL/min/1.73 m2.